(a) Field of the Invention
The subject invention as disclosed herein relates to an exercise device, and more particularly, but not by way of limitation, to a free standing, user manipulated devices for exercising or rehabilitating the rotator cuff muscles, and to the methods of using such a devices.
(b) Background of the Invention
The rotator cuff musculature is made up of the teres minor, infraspinatus, supraspinatus and the subscapularis muscles. In rehabilitation, sports activity, daily activity, repetitive work patterns, and injuries due to trauma, one can experience shoulder injuries specific to, or interrelated to the rotator cuff musculature. Also, through the repetitive throwing of an object, such as a ball, swinging of a racquet, striking of a volleyball, swimming, or any sport or other activity in which the arm is extended from the shoulder joint and rotated or moved, the rotator cuff muscles are susceptible to injury. The reason that this type of injury occurs is that the internal rotator cuff muscles experience the development of a greater level of strength as a result of repetitive overhead movement, especially when accompanied by a powerful follow through, as compared to the lesser strength developed by the external rotator cuff muscles in the same activity, thereby creating an uneven antagonistic muscle balance. As a result, there is a substantial chance for injury to the rotator cuff muscles, and more specifically to the weaker external rotator cuff muscles. This is because the external rotator cuff muscles, which are relatively weaker than the internal rotator cuff muscles, cannot maintain balance nor keep pace with the stronger internal rotator cuff muscles or the powerful pectoralis muscles during overhead and powerful follow through movement, and especially not during repetitive overhead and follow through movement, of the arm. Even in the absence of uneven antagonistic internal and external rotator cuff muscle balance, the rotator cuff muscle group is susceptible to injury when subjected to strain without having been properly warmed up. Another problem related to the rotator cuff musculature may come into existence following an injury to the shoulder, or after shoulder surgery, in which the individual may no longer have an adequate range of movement for either the external or the internal rotation of the shoulder and arm, for example, due to adhesions, or simply due to lack of muscle strength.
Heretofore there have been a variety of different types of exercise apparatus and devices used for rehabilitation due to sport and accident related injuries. In U.S. Pat. Nos. 3,315,959 to Carnielli, 4,592,545 to Sagedahl et al., 4,773,398 to Tatom and 5,039,391 to Johnson various types of exercise and physical therapy apparatus are described.
Carlson et al. U.S. Pat. No. 4,772,015 discloses a multi-purpose arm, shoulder and elbow exercise machine including a base a vertical rack and resistance means which can be adjusted vertically and pivotally using a rack-and-pinion system. The machine of this reference is not specifically designed for exercising rotator cuff muscles, and only briefly mentions the rotator cuff muscles. One embodiment taught by this reference includes an exercise arm which carries sliding or floating hand grip assembly. It discloses the use of an elbow stabilizer, and a non-physical range of motion limiter which sounds a "beep" when the desired range is reached. The elbow stabilizer secures the elbow, but does not hold the lower arm at 90.degree. angle to the upper arm during internal and external rotation of the shoulder muscle, which is of importance, as explained below. The audio range limiter is of limited value in limiting the range of motion, as the user is either sure to have some momentum that carries their motion past the "beep" range limitation, or an inefficient use of the equipment as the user slows down their momentum in anticipation of when the beep will sound. It also provides for various angle planes of movement, including the upper arm at 90.degree. abduction for internal and external shoulder rotation; however, the height in which this can be done is limited by the height of its mounting stand. Another embodiment includes a pair of pivoting caster assemblies, each including a pair of casters and a handle.
Pursley U.S. Pat. No. 4,553,747 discloses a rotator cuff exercise machine in the form of a cable pulley system that uses a weight stack, and which provides an elbow support surface on which the arm of a user can rest substantially horizontally while the user is in a sitting position. However, it does not teach the provision of elbow stabilization at 90.degree. upper arm abduction for internal and external shoulder rotation, and mentions the ability to work internal and external shoulder rotation in the horizontal plane of movement, but which provides no elbow support for this plane of movement.
Pipasik U.S. Pat. No. 4,817,943, discloses an exercise machine for the strengthening and development of shoulder muscles of an exercising person, and which mentions the use of an elbow stabilizer, but does not hold the lower arm at a 90.degree. angle to the upper arm during internal and external rotation of the shoulder, which is of importance, as explained below.
In other prior art, Aristolear, Jr. U.S. Pat. No. 4,957,281 discloses a rotator cuff therapeutic exercise apparatus which includes a stack of weights supported on a frame for movement along a working stroke from a rest position against gravitational force to a displaced position and an actuator mechanism on the frame adapted to be gripped and rotated by a hand of a user to move the weights along the working stroke. It is a big and bulky machine that uses a weight stack for resistance, and provides internal and external shoulder rotation with the upper arm at only one plane of usage, 90.degree. arm abduction. It mentions the use of an elbow stabilizer, but does not hold the lower arm at a 90.degree. angle to the upper arm during internal and external rotation of the shoulder, which is of importance, as explained below.
Miller U.S. Pat. No. 4,988,098 discloses a machine for exercising the rotator cuff of a user which includes a forearm support assembly for supporting a forearm of the user in a plane substantially transverse to the plane of the upright support frame, wherein the transverse plane also passes through the shoulders of the user in such a manner that the user's arm is positioned substantially in the transverse plane to isolate the user's rotator cuff. It requires a weight stack as the source of its resistance, which is very dangerous due to the potential for backlash and follow through, especially when dealing with muscles as vulnerable to injury as the rotator cuff muscle. Furthermore, it allows movement, to be performed in only internal and external shoulder rotation with the upper arm at one plane of 90.degree. arm abduction. It also mentions the use of forearm stabilizers, yet it provides no means for stabilizing the elbow in a manner which maintains the lower arm at a 90.degree. angle to the upper arm, nor does it provide a way to adjust the forearm pads to secure the lower arm.
Collins U.S. Pat. No. 4,944,508 discloses a mounting plate which may be adjusted from about 0.degree. to about 90.degree. for various planes of movement, and including a forearm support, but does not provide an elbow stabilizer. Furthermore, the mounting plate must be mounted to some structure, such as a table. This presents a problem of height adjustment for proper use. Furthermore, it neither teaches nor suggests the need to maintain a 90.degree. angle of the lower arm to the upper arm during the exercise of the rotator cuff muscles, nor does it teach a forearm stabilizer which is adjustable, or which allows the use of different size elbow stabilizers to accommodate users having different size elbows in order to lock and secure the upper and lower arms at a 90.degree. angle throughout the movement, in order to ensure proper isolation of the rotator cuff muscles. It provides for various planes of movement, including the upper arm at 90.degree. abduction for internal and external shoulder rotation, although it does not teach nor suggest the use of its system for internal and external shoulder rotation, nor for exercising or rehabilitating rotator cuff muscles.
Also found in the prior art was Anderson, et al. U.S. Pat. No. 5,058,574.
None of the known prior art patents neither specifically describe, teach, nor suggest an exercise method or device which is useful for the development of rotator cuff musculature by isolating the rotator cuff muscles during internal and external rotation against external resistance while fixing the upper heads of the ulna and radius bones of the lower arm of a user at the point where they join to form the elbow, while also fixing the associated scapula against movement, and then moving the lower arm internally and externally at a 90.degree. angle to the upper arm, to thereby cause the intermediate humerus bone, and especially the upper head of the humerus bone within the glenoid cavity, to be substantially isolated for movement during internal and external rotation of the lower arm against resistance. Additionally, there is no mention in the known prior art of the use of a forearm stabilizer which holds and secures the lower arm in 90.degree. abduction to the upper arm during internal and external rotation of the shoulder. Neither has the art taught or suggested such a forearm support in which the width of the support may be adjusted in order to stabilize and secure various size forearms. None of the known prior art teaches or suggests the inclusion of an elbow isolation element which is used solely as a means for isolating the rotator cuff muscles during exercise, by way of a combined elbow and arm support that locks and positions the lower arm at a 90.degree. angle to the upper arm. None of the known or cited prior art either teaches or suggests the use of a rotator cuff muscle development system which supports the elbow, and in which, rather than having a resistance device built into the machine, either no resistance is used, or outside sources of resistance are used. None of the prior art teaches or discloses a system which can be used with an elbow isolating device, and which can also be used for measuring and monitoring range-of-motion and limiting range-of-motion. None of the known or cited prior art either teaches or suggests the use of a physical stop by which either internal and/or external shoulder rotation range of motion can be limited. None of the known prior art teaches or suggests such an exercise method or device which, during its operation, minimizes compensatory movement patterns and the use of larger muscle groups, so that both the internal and external rotator cuff muscles can be better isolated and are strengthened equally to provide balance and antagonistic muscle harmony between the internal and external rotator cuff muscle groups for the purposes of providing true rotator cuff exercise, and to help prevent rotator cuff injuries, and for assisting in the provision of proper rehabilitation of rotator cuff injuries. None of the known prior art references appear to recognize nor to address the dangers of shoulder impingement which may occur when internal shoulder rotation range of movement is done in an excessive range while the upper arm is in 90.degree. abduction from the side of the body. All of the known and cited references teach the use of a hand grip which must be actively held by the hand of the user in order to move the exercise device, whereby the use of a grip requires the active involvement of the fingers, forearm and hand muscles, and movement and action at the wrist joint which results in excess and compensatory movement of these muscles, all of which interferes with and decreases the isolation of the rotator cuff muscles. None of the prior references teaches or suggests the use of a hand or arm receiver which does not have to be gripped. None of the known or cited prior art either teaches or suggests the use of a range of motion indicator, nor do they even recognize suggest the need for one. None of the prior art rotator cuff muscle exercise systems provides a capability for two users to use and work their rotator cuff muscles at the same time while on the same machine.